CMS approves six new N.J. Medicare ACOs

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January 10, 2013 at 1:50 PM

The Centers for Medicare and Medicaid Services announced Thursday 106 new Medicare Accountable Care Organizations have been formed and approved by the government. In New Jersey, six were approved across the state.

Accountable care organizations are groups of providers working together to streamline care coordination for populations of patients while making care better and more affordable. The Medicare demonstration ACOs allow hospitals, physicians and other providers to share savings accrued by working together.

Dr. Adam Jarrett, chief medical officer at Holy Name Medical Center in Teaneck, is now the executive director of the newly approved HNMC Hospital/Physician ACO. He said the hospital's ACO group is partnered with 150 staff physicians to implement the ACO.

"We think this is a good experiment that we wanted to be involved with, with Medicare, so we could understand how the ACO world works," Jarrett said.

He added that he's excited because for the first time, providers will be able to see the services provided by other health care providers for Medicare patients. Jarrett added that, while Holy Name has been able to work on keeping costs down within the walls of the building, the program allows collaborative efforts to keep costs down in the community.

Barnabas Health added a second Medicare ACO to its stable. The first was centered around hospitals and physicians in the northern part of the state; the ACO approved today is based around the company's Central Jersey providers plus CentraState Healthcare System's facilities and providers.

"The ACO is a big piece of that, it really continues the theme of delivering better integrated, more coordinated care for patients than certainly any health care system was used to," Scott said. "It certainly fits in with Meridian's overall strategy."

Scott said more than 500 clinicians affiliated with Meridian have signed on to participate in the ACO, including staff at each of the hospitals and at each provider facility in the system.

Scott said he's looking forward to rolling out increased IT and population management tools to the affiliated physicians through the ACO, so they have better information on patient risks and patient satisfaction.

In South Jersey, the Summit Health-Virtua ACO was approved Thursday, as well as the Atlanticare Health Solutions group.

Steven Blumberg, an senior vice president of AtlantiCare Health Solutions, said the addition of the CMS ACO to the system enhances the coordinated care programs already available through the system's employee program and Medicare Advantage.

"Being included in the Medicare shared savings program is a big leap forward for us," Blumberg said, adding that the model is gaining steam as more evidence is found that ACOs demonstrate the kind of quality improvements and cost savings suggested when originally proposed.

The sixth ACO, Accountable Care Network of New Jersey LLC, is one of three networks established by Walgreens, the national retail pharmacy chain. Walgreens established ACOs in Florida and Texas in addition to New Jersey. A call to Walgreens for comment was not returned before publication.

Four of the six ACOs contracted with QualCare Inc. to help with the application process. QualCare is in the process of spinning off the branch of the company that specializes in ACO applications into a separate company called Health-Lynx. AtlantiCare and Walgreens did not use QualCare.

In addition to the Barnabas North ACO, Atlantic Health, Hackensack University Medical Center and Optimus Healthcare Partners LLC had accountable care organizations approved by CMS in 2012.